Skip to main content Accessibility help
×
Hostname: page-component-848d4c4894-v5vhk Total loading time: 0 Render date: 2024-07-03T10:59:17.543Z Has data issue: false hasContentIssue false

61 - Meningeal cancer

Published online by Cambridge University Press:  04 August 2010

Neil A. Hagen
Affiliation:
University of Calgary, Calgary
Michael J. Fisch
Affiliation:
University of Texas, M. D. Anderson Cancer Center
Eduardo Bruera
Affiliation:
University of Texas, M. D. Anderson Cancer Center
Get access

Summary

Cancer can spread to the cerebral spinal fluid (CSF) and meninges, and rarely, can originate there. When cancer involves the meninges, it causes cancerous meningitis. It has clinical similarities to infectious meningitis in that it commonly causes confusion, drowsiness, a stiff neck, and other meningeal signs, and if untreated, causes death. It is different from infectious meningitis in that the time course is somewhat slower (many days or weeks) and it more commonly tends to cause focal neurological deficits. Meningeal cancer is a devastating clinical situation; it causes severe neurological impairment, and carries a grim prognosis despite treatment. Fortunately, distressing symptoms can respond to intervention.

Meningeal cancer is fairly common. About 5% of patients with metastatic cancer will develop clinically significant cancerous meningitis, although autopsy surveys show a higher prevalence, indicating it can be asymptomatic particularly in patients who are otherwise quite ill. A peculiar feature of the epidemiology of meningeal cancer is that some kinds of malignancies have a striking predilection to metastasize to the leptomeninges, such as melanoma. About 90% of patients who die from metastatic melanoma have central nervous system metastases, and this commonly includes the meninges. Other kinds of cancer are much less likely to metastasize to the leptomeninges, such as bladder or prostate cancer. However, it can occur in any kind of cancer. About 5% of patients who die from a malignant supratentorial glioma have meningeal spread of glioma at autopsy, but only rarely is gliomatous meningitis of any clinical significance.

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2003

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Olsen, M E, Chernik, N L, Posner, J B. Infiltration of the leptomeninges by systemic cancer; a clinical and pathologic study. Arch Neurol 1974;30:122–37CrossRefGoogle Scholar
Posner, J B, Chernik, N L, Intracranial metastases from systemic cancer. Adv Neurol 1978;19:575–87Google ScholarPubMed
Wasserstrom W R. Leptomeningeal metastases. In Neurological Complications of Cancer, ed. R G Wiley. New York: Marcel Dekker, 1995
Wasserstrom, W, Glass, J P, Posner, J B. Diagnosis and treatment of leptomeningeal metastases from solid tumors; experience with 90 patients. Cancer 1982;49:759–723.0.CO;2-7>CrossRefGoogle ScholarPubMed
Olsen, M E, Chernik, N L, Posner, J B. Infiltration of the leptomeninges by systemic cancer; a clinical and pathologic study. Arch Neurol 1974;30:122–37CrossRefGoogle Scholar
Posner, J B, Chernik, N L, Intracranial metastases from systemic cancer. Adv Neurol 1978;19:575–87Google ScholarPubMed
Wasserstrom W R. Leptomeningeal metastases. In Neurological Complications of Cancer, ed. R G Wiley. New York: Marcel Dekker, 1995
Wasserstrom, W, Glass, J P, Posner, J B. Diagnosis and treatment of leptomeningeal metastases from solid tumors; experience with 90 patients. Cancer 1982;49:759–723.0.CO;2-7>CrossRefGoogle ScholarPubMed
Meningeal carcinomatosis in breast cancer. This web site shows typical MRI scan findings in meningeal carcinomatosis, published in the New England Journal of Medicine. http://www.content.nejm.org/cgi/content/short/342/15/1093
Metastatic tumors to the brain and spine. http://medhlp.netusa.net/lib/mets.htm
The Nature of Cancer. http://www.carelife.com/cancer/med\_onc/nature\_cancer.html
Active Therapies for CNS Tumors. http://www.brain.mgh.harvard.edu/therapies.htm

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

  • Meningeal cancer
  • Edited by Michael J. Fisch, University of Texas, M. D. Anderson Cancer Center, Eduardo Bruera, University of Texas, M. D. Anderson Cancer Center
  • Book: Handbook of Advanced Cancer Care
  • Online publication: 04 August 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511527081.062
Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

  • Meningeal cancer
  • Edited by Michael J. Fisch, University of Texas, M. D. Anderson Cancer Center, Eduardo Bruera, University of Texas, M. D. Anderson Cancer Center
  • Book: Handbook of Advanced Cancer Care
  • Online publication: 04 August 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511527081.062
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Meningeal cancer
  • Edited by Michael J. Fisch, University of Texas, M. D. Anderson Cancer Center, Eduardo Bruera, University of Texas, M. D. Anderson Cancer Center
  • Book: Handbook of Advanced Cancer Care
  • Online publication: 04 August 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511527081.062
Available formats
×